5 Written questions
5 Matching questions
- explanation of benefits (EOB)
- medical necessity
- diagnosis code
- a a standardize value that represents a patien's illness, signs, and syptoms
- b adavance payments to a provider that covers each plan member's health care services for a certain period of time
- c paper document form a payer that shows how the amount of a benefit was determined
- d treament provided by a physycian to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, or its symptoms in a manner that is appropriate and provided in accordance with generally accepted standards of medical practice.
- e physician's opinion of the nature of the patient's illness or injury
5 Multiple choice questions
- a plan, program, or organization that provides health benifits.
- private or government organization that insures or pays for health care on the behalf of beneficiaries.
- .managed care network of health care providers who agree to perform services for plan members at discounted fees
- a managed health care system in which provides agree to offer heath care to the organization's members for fixed periodic payments from paln
- process of assigning standardize codes to diagnises and procedures
5 True/False questions
practice management program (PMP) → form that includes a patient's personal, employment, and insurance data needed to complete an insurance
copayment → a small fixed fee paid by the patient at the time of an office visit.
adjudication → series of steps that determine whether a claim should be piad
consumer-driven health plan (CDPH) → a type of managed care in which a high-deductible/low-premium insurance plan is combined with a pretax saving account to cover out-of-pocket medical expenses, up to the deductible limit
statement → a small fixed fee paid by the patient at the time of an office visit.